Check your Metabolic syndrome:
 

Heart attacks sans high risk factors - possible

- Dr. Sunil Seneviratna Epa (ex-President SLMA)

DR. EPA Sunil Seneviratna writing to the HealthWatch on Metabolic syndrome and heart attacks wishes to inform the public that a heart healthy person with no risk factors for a heart condition still could get an heart attack if he is Metabolic Syndromed.

This fact is little known among the public and since there was no Lipid Control guide lines issued for doctors in Sri Lanka the doctors too were paying little attention to this. However the SLMA has now met this void and corrected the position by issuing a set of guidelines on Lipid Control.

Metabolic syndrome

Dr. Epa says "Metabolic syndrome is diagnosed if a person has three or more of the following features":

1. Waist circumference over 90 cm in men and 80 cm in women.

2. Triglyceride over 150 mg/dl.

3. HDL cholesterol under 40 mg/dl in men and 50 mg/dl in women.

4. Blood Pressure over 130/85.

5. Fasting blood sugar 110 mg/dl.

Referring to a case of a young executive who suffered a heart attack recently, Dr. Epa said he had non of the conventional risk factors such as high cholesterol, family history, diabetes, high blood pressure or smoking and had been given an ok at a routine medical check up.

On closer examination he was found to be having Metabolic Syndrome which put him at high risk suffering a heart attack.

Unfortunately he was not aware of this condition and as a result didn't take any precautions. All that would have been necessary was to reduce little weight and to take regular exercise because all the features of this syndrome are correctable.

Dr. Seneviratne Epa hopes other doctors in Sri Lanka would follow these guidelines in cholesterol control.

Guidelines on the Management of Lipid Disorders in Sri Lanka was prepared by the NCD Committee of the SLMA and was released in March this year.

No agreed protocol on cholesterol control

Dr. Epa said there was no agreed protocol on cholesterol control in Sri Lanka and as a result there was overuse of drugs in some patients while others were under treated.

SLMA guidelines will streamline cholesterol treatment in Sri Lanka. He said the aim of this new clinic is not only to control cholesterol but also to reduce overall risk of coronary heart disease in a person.

For this end everyone is given a card with a colour code indicating the risk level and depending on the risk level a Cholesterol Goal or a target cholesterol value is given to each one.

It is a tailor made value for that person and he or she is expected to keep cholesterol level below this target value at all times. Drugs are prescribed only if the person's cholesterol is above the target value.

Each person will also be screened for what is called Metabolic Syndrome. This is a collection of features which would put a person at high risk of coronary heart disease.

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Dr Kan Tun recalls

DR KAN Tun WHO representative in Sri Lanka who is leaving the country after four years in office in his farewell message sent to HealthWatch recalls:

I arrived in Sri Lanka at the beginning of 2001 to take up the role of WHO representative for this country. I very quickly became immersed in the activities being undertaken by the WHO Country Office in collaboration with the Ministry of Health, which covered a spectrum of projects and programmes.

As a country in possession of a strong health sector infrastructure, we were able to channel our resources and technical expertise into areas supporting the Government that required strengthening, or updating.

There has been much success in combating the major communicable diseases that existed in Sri Lanka, this has been largely due to the implementation of a disease surveillance programme which has heightened the awareness of many a health worker, and the public at large in recognizing and seeking immediate accurate treatment for such illnesses.

As such there has been a noticeable reduction in the number of communicable disease, and epidemics have been kept to a minimum.

The introduction and implementation of strong, widespread information communication technology has been a major challenge for the Ministry of Health and WHO, however, the shift from manually kept information and a basic health information system to a more comprehensive and effective computerized system is well underway and early indications illustrate strong benefits from such an achievement.

Another important challenge has been the twenty year conflict that has had an enormous impact on the health system in the North East of the country, this has been compounded by the large displacement of people, damage to the health facilities and a shortage of qualified and skilled health care workers in this area.

In conjunction with the Government, the World Bank and WHO a programme of health system rehabilitation was mobilized to ensure accessibility to basic health services and strengthening and improving of the quality of healthcare.

Sadly the tsunami that took place last December, has also represented a huge challenge, in terms of loss, health and livelihood to many thousands of people here in Sri Lanka. More than 75% of the coastal belt of the island was affected, with many health facilities destroyed or damaged, and thousands of people injured, and displaced.

All of which placed immense strain on the remaining health infrastructure of the country. As health sector co-ordinator within the UN family, WHO put forward and implemented a number of health sector development projects.

A number of important activities were implemented including co-ordination of certain disaster relief activities, establishment and maintenance of an disease surveillance and early warning response, prevention of water and sanitation related disease, and provision of psychsocial and mental health care to the affected population. To date much of this activity is completed with some projects still ongoing.

Despite the many challenges that have arisen during my four years in Sri Lanka, I am delighted with the visible progress that we, WHO, have jointly made with our colleagues at the Ministry of Health and the numerous health partners who have assisted and supported these and many more activities.

I am extremely thankful for the co-operation that has been displayed in these quarters, and would like to congratulate all those involved, particularly friends within the Sri Lankan health sector from central, provincial and district areas, for the deep commitment that they exhibit to the progress and well being of this crucial area.

It has been my great privilege to offer my assistance in this arena, and I am very proud of the strong relationships that we have developed and the great strides we have taken together.

This week I will be leaving Sri Lanka to take up my new role as WHO Representative in Nepal, it will be with great sadness that I bid farewell to my colleagues and friends here, this island has become more than a second home to myself and my family and we have been made to feel very welcome and happy here for the last 4 years.

I wish my colleagues and the people of Sri Lanka every success in the ongoing recovery from the tsunami, and the continued excellent work that is taking place today in the health sector of this country.

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Using plastic containers in Micro-wave ovens: Is it health risky?

Dr. A.R.L. Wijesekara raises the question

IT is a fairly common practice for housewives to use plastic receptacles (e.g) empty plastic margarine and butter containers, for storage of all items of cooked food.

This is a very convenient and handy practice, but would necessitate the repeated refrigeration and micro-wave heating of their contents.

I would appreciate some authoritative information on the health hazards, if any, resulting from such a practice.

In other words, could this repeated micro-wave treatment result in a health hazard in the course of time, to the consumer of food items subjected to this treatment, consequent on any adverse reaction the micro-waves could have on the plastic.

I am also aware that many receptacles are advertised, invariably at a higher price, on the basis of these items being suitable for use in 'micro-wave' ovens. I would, indeed, like to know what guarantee there is for the consumer in respect of the authenticity of such 'declarations', and its hazard-free tacit implication.

HealthWatch :- We have referred this letter to the MRI for a reply. In the meantime we would like any-one who can speak on this with authority to write to us.

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Ecstasy on Medical trial

DR. VIRAJ Peramuna of the Colombo National Hospital speaking to the Healthwatch on the latest research on medicine said that once a banned drug Ecstasy is now undergoing trials to see whether it could be used as a cancer preventive.

He said according to the latest medical research information made available to doctors, the trial is being done in the Harvard University in USA on a terminally ill cancer patient. She is being given the powerful drug MDMA the other name of which is ecstasy.

He said a recent issue of the Newsweek also carries an article on this trial, where it is said that the US Food and Drugs Administration has also approved the use of this Ecstasy drug on the trial on this patient and a few others also who are terminally ill with cancer.

The research is on to see whether ecstasy could unlock anxiety by targeting areas of the brain that don't usually respond to antidepressants.

The trial has now been on for nearly a year. The Newsweek article Dr. Viraj says reports that the Drug Enforcement Authorities in US are not in favour of the trial saying that it could be a wrong signal to the kids who will say "Hey look, Ecstasy is becoming a medicine now".